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Maharashtra: 50 per cent of PHCs without toilets in tribal blocks of Nandurbar

In Nandurbar’s population of 16 lakh, the two blocks constitute 30 per cent of the total population with only rural hospitals and PHCs available for providing healthcare.

At least 50 per cent of the primary health centres (PHCs) in Nandurbar’s remote stretches do not have a toilet facility for its doctors and nurses, a report ordered by the state government for Maharashtra’s northern tribal district shows. Moreover, construction work is pending in 46 per cent PHCs, forcing such centres to either function from the gram panchayat’s office or sub-centres. In a public health system, PHCs come lowest in the hierarchy, acting as the first point of contact for the local population by providing medications for common infections, fever, snake bites, by conducting screening camps and by providing a referral centre for deliveries of pregnant women. Nandurbar’s two remote tribal blocks — Dhadgaon and Akkalkuwa — have 26 PHCs. In Nandurbar’s population of 16 lakh, the two blocks constitute 30 per cent of the total population with only rural hospitals and PHCs available for providing healthcare.

On February 6, The Indian Express had written about 37-year-old Dr Revati Joshi, a medical officer in Dhadgaon PHC of Bilgaon, who was forced to relieve herself in the open due to lack of toilet facility. For the last 11 years, Joshi had been demanding proper sanitation facilities for the medical staff working on 24-hour duty in tribal health centres. She travels 23 km to reach her home to take a bath before reporting back to work. Following the report, a toilet was constructed within a month in Bilgaon PHC. The state health department also ordered a probe into other PHCs in the tribal blocks. A fresh report submitted by the district health officer shows that of 26 PHCs, toilets are lacking in 13 and construction is required in 12. Despite a massive Swachh Bharat Mission under way in India since 2014, female doctors and nurses have complained of lack of sanitation amenities in government health centres. In 26 PHCs surveyed, every centre has either a female doctor or female nurse posted.

Of 111 sub-centres in the two tribal blocks, 30 per cent (33) do not have a toilet for doctors and staffers. Construction work is pending in 20 sub-centres. “Most of us have to relieve ourselves behind a tree as the closest huts are located far away and even those have no toilets. Open defecation is common here,” said a doctor attached with a PHC in Dhadgaon. “In Dhadgaon, of 13 required, only five PHCs have been constructed. In certain centres where construction is over, flooring is absent. The working condition of medical officers is very poor. They have to work for 24 hours at a stretch and there is no place to even rest,” said Latika Rajput, a local activist, adding that one PHC in Khuntamodi was so badly constructed that doctors refused to work in it. It remains defunct now. “The issue is also of constructing quarters for doctors in sub-centres and PHCs. They sometimes work for two-three days at a stretch but have no room to rest,” Rajput added. Some sub-centres were found to have no doors, officials said.

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According to local officers, the terrain in Nandurbar is hilly, making transportation of construction material a problem to these remote PHCs. Over eight PHCs in Nandurbar have been built using fibre structure as labourers found it hard to carry construction material. However, fibre structures with no air-conditioning were too hot to work, doctors complained. “We also face issues of land ownership. Most of this is forest land. Ownership under government takes time,” said district collector Mallinath Kalshetty.

According to the report, proposal for land to construct new PHCs and toilets have been made in eight cases of which in three projects, approval has still not come. A state government official also pointed out that construction quality of PHCs and hospitals have been found poor with leakages in operation theatres reported in newly constructed buildings. “We are taking up the issue of sanitation seriously in rural areas. In the coming months, all primary health centres will have a toilet facility for medical staff in Nandurbar,” said Vijay Satbir Singh, additional secretary (health).

First uploaded on: 05-04-2017 at 03:43 IST
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